Accuracy of Ultrasound Jugular Venous Pressure Height in Predicting Central Venous Congestion
Authors: Libo Wang, Jonathan Harrison, Elizabeth Dranow, Nijat Aliyev, Lillian Khor
Journal: Annals of Internal Medicine (2022)

LettersMay 2022Accuracy of Ultrasound Jugular Venous Pressure Height in Predicting Central Venous CongestionLibo Wang, MD, Jonathan Harrison, MD, Elizabeth Dranow, PhD, Nijat Aliyev, MD, Lillian Khor, MSCI, MBBChLibo Wang, MDDivision of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, Utah, Jonathan Harrison, MDDivision of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, Utah, Elizabeth Dranow, PhDDivision of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, Utah, Nijat Aliyev, MDDepartment of Medicine, Duke University Medical Center, Durham, North Carolina, Lillian Khor, MSCI, MBBChDivision of Cardiovascular Medicine, University of Utah School of Medicine, and George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UtahAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0118 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: The observation that a single cutoff for uJVP does not fully describe the complete receiver-operating characteristic profile of our validated ultrasound examination is astute. Physical examinations traditionally are taught in a simplistic manner with dichotomized cutoffs (such as traditional JVP), which is the reason for our more simplistic presentation of a singular cutoff. Upon reviewing the presented LRs generated in Dr. Fischer's analysis, we agree that the multilevel LRs bring a more pragmatic nuance to uJVP measurement. At a uJVP of 12 cm or greater, the LR for predicting elevated RAP approaches infinity; this would translate to close ...References1. Deol GR, Collett N, Ashby A, et al. Ultrasound accurately reflects the jugular venous examination but underestimates central venous pressure. Chest. 2011;139:95-100. [PMID: 20798190] doi:10.1378/chest.10-1301 CrossrefMedlineGoogle Scholar2. Seth R, Magner P, Matzinger F, et al. How far is the sternal angle from the mid-right atrium. J Gen Intern Med. 2002;17:852-6. [PMID: 12406357] CrossrefMedlineGoogle Scholar3. Davison R, Cannon R. Estimation of central venous pressure by examination of jugular veins. Am Heart J. 1974;87:279-82. [PMID: 4812363] CrossrefMedlineGoogle Scholar4. Simel DL, Rennie D. The Rational Clinical Examination: Evidence-Based Clinical Diagnosis. McGraw-Hill Education; 2009. Google Scholar Author, Article, and Disclosure InformationAffiliations: Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, UtahDepartment of Medicine, Duke University Medical Center, Durham, North CarolinaDivision of Cardiovascular Medicine, University of Utah School of Medicine, and George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UtahDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-2781. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAccuracy of Ultrasound Jugular Venous Pressure Height in Predicting Central Venous Congestion Libo Wang , Jonathan Harrison , Elizabeth Dranow , Nijat Aliyev , and Lillian Khor Accuracy of Ultrasound Jugular Venous Pressure Height in Predicting Central Venous Congestion Ahmad Sabry Saleh Accuracy of Ultrasound Jugular Venous Pressure Height in Predicting Central Venous Congestion Brett G. Fischer Metrics May 2022Volume 175, Issue 5Page: W54KeywordsArea under the curveCatheterizationJugular venous pulseNegative predictive valueObesityOverweightPositive predictive valueReceiver operating characteristic curveSpecificityUltrasound imaging ePublished: 17 May 2022 Issue Published: May 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...